Social Justice and the Legal Determinants of Health: Public Health Ethics Special Symposium

Press release issued: 3 August 2020

The Centre for Health, Law, and Society (CHLS) was founded on the recognition of the importance of looking both at and far beyond the healthcare system when seeking to understand the links — for better and for worse — between health, law, and social justice. These links and the issues surrounding them are explored at national and global levels in a new Public Health Ethics journal special symposium on the legal determinants of health, following the CHLS symposium ‘Mapping the Path to Global Health with Justice.’

The Covid-19 pandemic crisis has demonstrated to everyone the unavoidable connections between health, law, and social (in)justice. It has accordingly amplified calls for urgent attention to the legal determinants of (ill) health, and the roles that law can and should play in addressing questions of individual and population health.

The University of Bristol Law School has been highly responsive on many of the varied challenges and complexities for law in the Covid-19 outbreak, building on a longstanding tradition of asking and seeking answers to the questions that we face as a society.

A key output exploring the questions of health, law, and social justice at national and global levels was published in a special symposium of Public Health Ethics last week, led by CHLS colleague Professor John Coggon and Professor Lawrence O. Gostin, Director of the O’Neill Institute for National and Global Health Law, Georgetown University.

The journal special symposium follows a CHLS symposium event held in October 2019, hosted to mark the publication of the ground-breaking Lancet-O’Neill Commission Report on the Legal Determinants of Health.

At that event, Professors Gostin and John T. Monahan, lead authors on the Lancet-O’Neill Report and world-leading authorities on public and global health law, presented the key work and findings of the Commission. The symposium also included a critical keynote from Professor Sarah Hawkes, focused on gendered harms — including through apparent gender-neutrality — in global health and law. The event concluded with a panel discussion that approached legal determinants of health and health with justice from a wide range of methodological and critical perspectives.

Alongside the collected papers, which include an article by CHLS Co-Director Dr Sheelagh McGuinness and UCL’s Professor Sir Jonathan Montgomery, and a piece by Professor Coggon, the special issue closes with a paper by Professors Coggon and Gostin. This comments on the practical challenges for governments globally, and reflects on the needs for research in public health ethics and law as responses to the pandemic crisis develop and are implemented. In it, they write:

“The challenges of the acute and sustained events consequent to COVID-19, across the globe, have already laid bare the sheer vulnerability of human health, the fragility of social institutions that we may take for granted, our astounding interconnectedness, and the need that these bring for equitable, transparent methods of coordination and regulation; of good governance, including for the public’s health. The need for brave and contemplated political leadership is clear; leadership that looks globally, not just nationally. And however different countries’ responses come to be judged in hindsight, the power of law, its limits, its risks and its relationships to health and other vital values, could not be made starker.”

Reflecting on the Public Health Ethics special symposium, Professor Coggon said:

“The important place for law, both in protecting and in promoting health, necessarily extends far beyond medicine and healthcare. As the COVID-19 crisis shows, clinical ethics and medical law are areas of critical concern, but a predominant focus on these must not overshadow broader and no less consequential questions about wider legal, political, and social structures that directly and indirectly impact our health.

"And as this new special symposium of Public Health Ethics shows, we need to approach these from multiple critical perspectives, to account, for example, for gendered harms and to give due regard to the disproportionate and unfair impacts on communities whose members suffer wider social disadvantage. Equally, the papers show the importance of critically debating how law and governance both serve the public’s health, and how they may cause harms either to health or to the protection of other vitally important values.”

Read the full journal special symposium online: The Legal Determinants of Health

Further information

Professor John Coggon is Chair in Law at the University of Bristol and a founding member and former Co-Director of the Centre for Health, Law and Society. His primary areas of expertise are in Health Law and Policy, with particular points of focus in Public and Global Health, and Mental Capacity Law. His research is rooted in legal, moral, and political theory, and aims to bring insights from these to policy and practice.

Dr Sheelagh McGuinness is Reader in Law at the University of Bristol and Co-Director of the Centre for Health, Law, and Society. She has wide-ranging interests in health law and policy, particularly the regulation of reproduction and reproductive justice.

The Centre for Health, Law, and Society (CHLS) promotes cross-disciplinary and cross-sector perspectives on the impacts of law and governance on physical, mental and social wellbeing. Based within the University of Bristol Law School, the CHLS comprises leading scholars whose work focuses on wide-ranging practical areas from within and far beyond health care systems, including clinical medicine, reproductive care, mental health, social care, and public and global health.

The Law School Coronavirus Research Hub brings together the work of academics at the forefront of global efforts to mitigate against the impact of COVID-19 through law and policy adaptation, and to understand the immediate and longer-lasting impacts of the pandemic.